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Thyroid and Bone Pharmacology
Exam IV
7
Pharmacology
Professional
04/20/2010

Additional Pharmacology Flashcards

 


 

Cards

Term

 

 

 

Levothyroxine

Definition

Tx: Drug of choice for thyroid hormone replacement,

Thyroid cancer: suppresses pituitary TSH,

Myxedema coma (urgent!)

Ax: Synthetic hormone, peripheral activation to T3, acts on mitochondria and alters gene expression

SE: rare if proper dosing, excess dosing causes hyperthyroidism, can exacerbate acute MI

Ms: oral F=80%, ~35% converted to T3, t½=7days,

takes a few weeks to work

 

Term

 

 

 

Propylthiouracil

Methimazole

Definition

Tx: hyperthyroidism, do not use methimazole in pregnancy (crosses placenta, enter breastmilk),

Ax: Thioamines - compete w/ thyroglobulin for iodine→↓T3/T4 synth., propyl: inhibits thyroid peroxidase + T4/T3 conversion, methim: inhibits thyroid peroxidase only, potent 

SE: goitrogens:↓T3/T4→↑TSH → gland hypertrophy,

agranulocytosis, arthralgias, rash (lupus-like), bradycardia, propyl: depletes prothrombin, methim: BM suppression

Term

 

Radioactive Iodine

(I-137)

Stable Iodide

(I-127)

Definition

Tx: 131: hyperthyroidism (Graves, hot nodulethyroid, etc.)

127: short-term block in radiation emergencies, ↓vascularity before surgery

Ax: 131: selective permanent thyroid destruction,

127: High levels inhibit T3/T4 synth. + release (Wolff-Chaikoff effect)

SE: Hypothyroidsim (overshoot), NOT for pulm edema or TB pts, 131: may worsen proptosis, serious fetal problems, 127: may worsen toxic goiter

Ms: enter thyroid follicular cells via Na+/I- symporter

Term

 

 

Alendronate

Etidronate

Definition

Tx: Paget's, osteoporosis, alendro: male osteoporosis, etidro: hypercalcemia of malignancy/osteolytic cancer, NOT for hypocalcemia tx or preg.

Ax: Bisphosphonates inhibits mevalonate pathway in osteoclasts, blocks bone resorption→lower serum Ca2+ levels

SE: alendro: esophageal erosion if can't stay upright ½ hr, etidro: ↑fracture risk

Ms: ↓absorption w/ food (milk)

Term

 

 

 

Clacitonin

Definition

Tx: ↓serum Ca2+ in Paget's, ↑kidney excretion of Ca2+, Na+, PO4--, NOT for lactating women

Ax: secreted by thyroid parafollicular cells, binds + inhibits osteoclasts

SE: Flushing, rash, N/V, injection site inflamm.

 

Term

 

 

 

Calcium Gluconate

Definition

Tx: Vitamin D-dependent rickets, hypoparathyroidism

Ax: Provides Ca2+

Ms: IV for severe cases, less irritation than others

 

Term

 

 

 

Calcitriol

(1,25 (OH)2 Vit D3)

Definition

Tx: Hypoparathyroidism, may ↑ bone formation, chronic renal dialysis pts, 

Ax: ↑Ca absorption in GI, ↑bone mineralization, ↑renal Ca/PO4 reabsorp, inhibits PTH synth/release

SE: NOT for hypercalcemia pts, hx kidney stones, or preg, Metal taste, N/V

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